Our No. 1 cause of death in Canada remains heart disease. The burden of illness is not only limited to the impact on the cardiovascular system itself but to something as important and as simple as being mobile. Obesity is one of the leading risk factors for cardiovascular disease. Did you know that diseases of the heart and circulation system are second only to arthritis as a major cause of disability in people over the age of 60?
This week, in the Archives of Internal Medicine, is a study looking at what this at-risk population can do to improve their health.
In this research, the participants were studied to look at the effect of weight loss, physical activity and lectures on successful aging on their ability to improve their mobility.
The physical activity arm was designed to gradually increase physical activity in the home environment so that 30 minutes of moderately intense activity was done for a total of more than 150 minutes per week. The weight loss arm was aimed at reducing calories to produce a weight loss of 0.3 kg per week. The third intervention was focused on teaching successful aging without formal interventions for weight loss and exercise, although they were taught about the importance of each.
The outcome studied was something called a 400-meter walk time in seconds.
What was found was that the COMBINATION of both weight loss and physical activity together is what worked best. The weight loss improved the functional health of these older people with underlying cardiovascular disease. This group who had both weight loss and increases in physical activity improved their mobility by as much as 5 per cent. For those who started with the most impaired mobility, their improvement was as great as 20 per cent!
Often, we don’t emphasize the importance of independent mobility. Walking unassisted is critical to overall independence within a community.
In another study out this week from the American Heart Association in the journal Hypertension is a study looking at lowering blood pressure in middle aged women. Researchers found that the systolic BP – the upper number that we get as a reading when the heart contracts — is a very important risk factor for cardiovascular complications, particularly in middle aged women.
There are several risk factors for heart disease, but three major risk factors remain reversible, such as high systolic BP, high cholesterol and smoking. Of the three, high systolic BP is particularly important.
A rise of 15 mm mercury increase in the systolic BP, in this international collaboration, was found to increase the risk of cardiovascular disease in women by 56% compared to 32% in men.
The message here is to get more aggressive about identification and treatment.
While our first study speaks to the importance of weight loss and physical activity in increasing mobility in this at risk population, the approach will have great benefit in hypertensive patients as well!